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Association Of
Nuclear Medicine Physicians Of India

home

Membership Application

Name

Name as on ID card

Password

Date of Birth

Sex

Male
Female

Address for Correspondence

Phone No

Land No

Place of work

Designation

Career Details :

1.Medical Registration

Reference

Date/Month/Year

2. Training in Nuclear Medicine

Course

Joining Date

Passed Date

3. Experience in Nuclear Medicine:

Year wise Till date

4. Membership in other societies if any:

IMA SNM-I API IRIA ICNM NCSI

Declaration:

I hereby declare that the information furnished above are true

I agree to abide by the rules and regulations of the Association as on now, and as and when amended in the future.

Tranaction Details / Transaction Number

Membership Type

Regular Member

3000

One time payment Student Member
(to be promoted as regular)

2000

One time payment Associate Member

2000

(for 6 years) Founding Member Honorary Member Corporate Member

10000

(for 6 years)

Career Details :

Send cheque or DD to...

Dr Zakir Ali

Head, Dept of Nuclear Medicine
Basavatarakam Indo-American Cancer Hospital
Road No. 14, Banjara Hills
Hyderabad – 500 034
Ph: Off 040 - 23551727
Mobile +91 9912225307
Email anezak@gmail.com

For online transfer bank details...

Bank Account

Name of account: ANMPI
Bank: Union Bank of India
Branch & address: Road No 14 Banjara Hills Branch
Road No. 14, Banjara Hills,
Hyderabad-500034
Account no : 151411100000229
IFSC code: UBIN0815144

Association of Nuclear Medicine Physicians Of India (ANMPI)
C/O Indo-American Cancer Institute
No.14 Banjara Hills,
Hyderabad, Andra Pradesh,
India - 500034

Mail : anmpi.webcor@gmail.com

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